Curing Maifip’s defects

The proposed budget for the Medical Assistance to Indigent and Financially Incapacitated Patients (Maifip) is another sticking point roiling deliberations in the bicameral conference committee (bicam) on the proposed P6.793-trillion national budget.

Besides the deadlock over the reduced budget of the Department of Public Works and Highways, bicam members are at an impasse over funding for Maifip, which was part of the National Expenditure Program submitted to Congress, but with a proposed budget of only P24.2 billion.

Lawmakers recognize the necessity of retaining the program, but disagree over how much the government should spend to cover the essential health-care services of indigent Filipinos.

The House of Representatives version of the budget bill, known as the General Appropriations Bill, proposed P49.2 billion for Maifip, but was drastically reduced by the Senate to P29 billion. This week, when select representatives from both chambers began meeting for bicameral deliberations, the proposed amount increased to P51.6 billion (from P42 billion this year), with the House contingent arguing that this increase was necessary to fully implement the zero balance billing (ZBB) program of the Marcos administration.

Sticking to their guns, several senators have insisted on the lower amount (P29 billion), presumably to address concerns that Maifip is another tool for political patronage, as it requires indigent patients to obtain guarantee letters (GLs) from lawmakers to access the fund.

Pork barrel. Civil society watchdogs have labeled Maifip and three other controversial social aid programs as a form of pork and patronage: the Assistance for Individuals in Crisis Situations, Tulong Panghanapbuhay sa Ating Disadvantaged/Displaced Workers, and the now-defunded Ayuda para sa Kapos ang Kita Program.

On Sunday, Cardinal Pablo Virgilio “Ambo” David added his voice to the growing disenchantment over the Maifip program, calling it another form of “health pork barrel” (see “Cardinal David hits Maifip budget hike as ‘violation of human dignity,’” Nation, 12/14/25).

Moreover, in a manifestation addressed to bicam members, Senate Deputy Majority Leader JV Ejercito has warned that increased funding for Maifip could undermine the Universal Health Care Act because it “risks trading higher PhilHealth participation in hospital bills, lower out-of-pocket expenses, and even the dignity of patients for political patronage.”

Do we really need Maifip at this point?

Maifip provides financial assistance for medical expenses to eligible applicants, including indigent patients and financially disadvantaged individuals. The fund alleviates the financial burden of medical care, enabling qualified patients to access the treatment they need.

Funds LGU hospitals. However, Maifip became redundant following the ZBB program announced by President Marcos during his State of the Nation Address last July, as ZBB does not require any GLs. Patients, regardless of their occupation or financial means, can receive free medical treatment in any of the 78 Department of Health (DOH)-administered hospitals nationwide, as long as they stay in basic accommodation during their confinement.

According to Malacañang, over a million Filipinos have benefited from ZBB in just four months in response to Mr. Marcos’ directive to improve Filipinos’ access to quality health care.

However, a significant gap exists: DOH hospitals may not have sufficient beds to accommodate the influx of patients who are eligible for free medical coverage. Therefore, it is necessary to utilize the 55 Level 2 and 3 hospitals operated by local government units (LGUs).

But Health Secretary Teodoro Herbosa has devised an innovative plan to redirect Maifip funds to expand the ZBB program, and this solution has the potential to break the impasse in the bicam. In a nutshell, Herbosa wants to retain Maifip, but use its funding to bankroll the catastrophic health fund and expand the ZBB program to LGU hospitals. (see “DOH proposes 80% of Maifip to fund ‘zero balance’ billing,” Headlines, 12/16/25).

“Since by virtue of the Special Provision, the funds will transfer directly from DOH hospitals to LGU hospitals and will be reckoned/liquidated by actual hospital bills, there is really no need for GLs. Just like in ZBB at DOH, GLs are superfluous,” DOH Assistant Secretary Albert Domingo told this columnist. “While waiting for the new hospitals to be built, we can ‘buy’ the unused hospital beds of big LGU hospitals to increase capacity,” he explained.

Both Herbosa and Domingo are correct. Instead of removing Maifip, the bicam can retain it and use the P51 billion to expand the ZBB program, so that patients in countryside can also receive medical help in LGU hospitals. By combining Maifip and ZBB, the government will finally achieve its goal of reducing patients’ out-of-pocket health-care expenses and increasing access to universal health care.

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